JERRY LEE HALVERSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

ACTIVE

Business

Title

First Name

JERRY

Middle

LEE

Last Name

HALVERSON

Business Name

JERRY LEE HALVERSON MD

Original Issue Date

09/08/2020

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

FITCHBURG

State

Zip

53711

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023